Provider Demographics
NPI:1659454593
Name:PACIFIC HORIZON MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:PACIFIC HORIZON MEDICAL GROUP INC.
Other - Org Name:PACIFIC HORIZON MEDICAL GROUP INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-292-5484
Mailing Address - Street 1:2351 CLAY ST
Mailing Address - Street 2:SUITE 512
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1931
Mailing Address - Country:US
Mailing Address - Phone:415-292-5477
Mailing Address - Fax:415-292-5490
Practice Address - Street 1:2351 CLAY ST
Practice Address - Street 2:SUITE 512
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1931
Practice Address - Country:US
Practice Address - Phone:415-292-5477
Practice Address - Fax:415-292-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty